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ABSTRACT Introduction & Objective: Enuresis is defined as involuntary voiding. It is a socially disruptive and stressful condition which affects around 15% of five years old children and up to 1% of adults. Aim the aim of this study was to assess the efficacy of desmopressin (nasal spray) and oxybutinin combination therapy in treatment of patients with primary nocturnal enuresis that were resistant to single drug therapy. Materials &Methods : This study is a prospective clinical trial conducted on patients aged 5-15 years old referred to urology clinic due to nocturnal enuresis. After taking history , physical examination , checking laboratory test , and ruling out the organic causes patients were treated with vasopressin or imipramin or oxybutinin at first. If no responses to this treatment was observed after 3 weeks, then the patients were treated by combination therapy ,giving desmopressin (10-20μg) and oxybutinin 2.5-5 mg) at bed time for 4-6 months. 70 patients were treated by combined therapy and then patients were followed up evaluated for responses, relapses and side effects of this drugs . Results :The results demonstrate the efficacy of this treatment. 60 % of patients were responded completely, 34.3% partially responded and no response was found in 57% of cases. 5.7% of patients developed minor side effects with combination therapy. Finally 44.3% of patients showed partial or complete relapse of enuresis 1 month after treatment . Conclusion : Based on these results , we can suggest that children with nocturnal enuresis who are resistant to single drug therapy, can be treated with this combination therapy . Reduction of urinary output and thus lowering of bladder filling by desmopressin , decreases the onset of inhibited bladder contraction and enhances the activity of oxybutinin. However due to cost and shortage of this drugs, we recommend this treatment only for patients with no response to single drug therapy , or other current therapies.

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ABSTRACT Introduction & Objective: Depression is known as a disorder that results in physical disorders, increases different diseases or mortality. Group psychotherapy is used to treat and reduce depression and physical function in depressive patients effectively. Group psychotherapy requires structured and organized group process and defined goal. The purpose of this study was to determine the effect of group psychotherapy on physical function of major depressive patients admitted in psychiatric wards in Hafez and Ibn-Sina hospitals. Materials & Methods : In this quasi-experimental study, group psychotherapy effect on three aspects of physical function, limited role playing resulting from physical problems and physical pain in 65 depressed patients admitted in psychiatric wards in Hafez and Ibn-sina hospitals, affiliated to Shiraz university of medical sciences (1382) with available sampling was carried out. 35 patients were included in case group and 35 patients in control group. A 36-item life quality questionnaire and a questionnaire of demographic characteristics with 13 items were used for data collection. The researchers completed related questionnaires for case group before group psychotherapy units about 1-1.5 hours. One month after group psychotherapy termination the above questionnaires were completed for 30 patients again (5 patients excluded). For control group, the first pretest was done, then without intervention one month after discharge, post test was completed. The data were analyzed by SPSS soft ware and statistical tests. Results: Results of this study showed that group psychotherapy was more effective on the three aspects of physical function, limited role playing resulting from physical problems and physical pain in case group than in control group and the difference was statistically meaningful (p<0.001). Conclusion: Group psychotherapy is recommended as one of the treatments of depression for improvement of physical function, physical pain relief, which lead to reduction of depression in major depressive patients.

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Introduction & Objective: Electroconvulsive therapy (ECT) is used widely in psychiatric practice. The goal of anesthesia for ECT is the prevention of complications such as discomfort, fractures, aspiration of gastric contents and hypoxia. However, general anesthesia can cause some adverse effects as hypoxia. Prevention and treatment of hypoxia is important due to its undesirable effects on seizure duration and cardiovascular system. This study was designed to detect the incidence and probable times of desaturation in patients receiving ECT. Materials & Methods: This prospective randomized clinical trial was carried out on 100 patients (18-50 y/o) with ASA I or II who were scheduled for ECT. After pre-oxygenation and similar anesthesia induction the patients received ECT. The patients were ventilated by oxygen and face masked until the return of their spontaneous respiration with adequate tidal volume and respiratory rate. Then they were transferred to recovery room where there was no oxygen supplementation. Oxygen saturation was measured by a Nell core pulse oximeter and was recorded at six stages: before and after anesthesia induction, during ECT, after ECT, 5 minutes after entering recovery room and before leaving there. The data were analyzed by standard statistical tests using SPSS software Results: Data analysis revealed that desaturation was not noticed at any stage except for the 5th stage (5 minutes after entering recovery room), when 13% of patients developed Sao2% less than 90%. Also there was a significant difference between Sao2% of patients between this stage (5th) and other stages (p<0.001). Conclusion: According to our findings, appropriate oxygen supplementation and pulse oximetry monitoring during recovery period after ECT can be recommend

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ABSTRACT: Introduction & Objective: In spite of several treatment methods which are being used to treat exudative age-related macular degeneration (ARMD) like laser therapy, Intravitreal steroids injections or anti-vascular endothelial growth factors (VEGF), no method has been yet presented as the best treatment way. This study aimed to assess the effectiveness of combined transpupillary thermotherapy (TTT) with subtenon triamcinolone acetonide (TA) injection in treatment of choroidal neovascularization (CNV) in patients with ARMD. Materials & Methods: In this clinical trial, 63 eyes of 57 patients with CNV secondary to exudative age-related macular degeneration (ARMD) were studied. All CNVs (including 20 predominantly classic and 43 predominantly occult lesions) were treated with diode laser (810nm). In 20 eyes with predominantly classic CNVs, 20 mg and 40 mg subtenon triamcinolone was injected in 12 and 8 eyes respectively. The patients were followed for a mean of 9.1 months (ranging from 5.5 to 16 months). The average number of treatment sessions was 1.25. In 43 eyes with occult CNV, 20 mg and 40 mg subtenon triamcinolone was injected in 31 eyes and in 12 eyes respectively. Mean follow up time was 12 months (4.5 to 23 months). Mean treatment times was 1.17. A variable spot size of 0.8, 1.2, 2 and 3 mm was used depending on the size of CNV and treatment was given in one area for 1 minute. Thermotherapy was adminstered through a contact lens at a power range between 120-560 mw. At the end of treatment, each patient randomly received 20 mg or 40 mg subtenon triamcinolone acetonide injection in superotemporal quadrant. Outcome was assessed with clinical and angiographic examination.collected data were analyzed by one-sample and paired –sample T test, using SPSS software. Results: At the end of the study in first group, visual acuity remained stable (0 to ± one line) in 14 out of 20 (70 %) of eyes, improved (> one line) in 2 of 20 (10 %) eyes and showed a decline (> one line worsening) in 4/20 (20 %) eyes. In second group thirty one eyes (72.1 %) had stable vision (± 1 line), 4 eyes (9.32 %) had better vision more than 1 line and 8 eyes (18.6 %) had more than 1 line decrease in vision. Conclusion: All CNVs were closed in last follow up. No statistically significant difference was found between two groups in clinical and functional with 20 mg and 40 mg injection of subtenon TA. Combined TTT and subtenon injection of TA in eyes with exudative ARMD can be an effective method to stabilize visual acuity of these patients.

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ABSTRACT: Introduction & Objective: One of the most common disorders of the knee joint in adult is patellofemoral pain syndrome. Sometimes it becomes chronic and causes activity limitation. This study aimed to compare the efficacy of exercise therapy with Transcutaneous Electrical Nerve Stimulation on improvement of pain intensity, knee function, muscle atrophy and range of knee flexion. Materials & Methods: This double-blind, randomized clinical trial was carried out in Zahedan Razmejo-Moghadam Physiotherapy Clinic, in 2007. Thirty-two patients with patellofemoral pain syndrome were recruited through simple non-probability sampling. Subjects were randomly assigned to one of the equal groups, exercise therapy (including hip, knee, and leg muscles strengthening and stretching exercises) or electrical stimulation group. Before and after intervention, we assessed pain through Visual Analog Scale (VAS) (ordinal), function (ordinal) with Knee Injury and Osteoarthritis Outcome Score (KOOS), thigh circumference with tape measure (centimeter) and range of knee flexion with goniometer (degree). A 10 session treatment program, three sessions per week and one hour per session was performed for both groups. Independent t-test or Mann-Whitney U and paired t-test or Wilcoxon were used for comparison between the pretreatment and post treatment results between groups and within groups, in SPSS software, respectively. Results: The mean total score of knee function increased from 100.53±19.25 to 130.87±18.25 in the electrical stimulation group and from 107.67±22.69 to 131.47±15.11 in the exercise therapy group (p=0.001). The mean score of knee function subscales including symptoms, pain, functional limitation, recreational activity, and life style improved in both groups (p<0.05). The pain score and range of knee flexion improved in both groups (p<0.05). After treatment, range of knee flexion significantly increased in the exercise group compared with the electrical stimulation one (p=0.008). Conclusion: Both of the exercise therapy and transcutaneous electrical nerve stimulation are effective in treatment of patellofemoral pain syndrome. However, exercise therapy is more effective increasing in the range of knee flexion.

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ABCTRACT Introduction & Objective: Chronic respiratory diseases are the most prevalent late sequels of sulfur mustard gas injury among Iranian chemical warfare victims. Chest physiotherapy is one of the useful methods in care, cure and infection prevention of these patients. The aim of this study was to determine the short-term effect of chest physiotherapy on spirometric indices in chemical warfare victims exposed to sulfur mustard gas. Materials & Methods: In this study, 27 of the chemical warfare victims with respiratory diseases were selected. Chest physiotherapy including postural drainage percussion and vibration were used in four positions for all patients. Pulmonary function test (PFT) was obtained before (baseline), immediately and 20 minute after the chest physiotherapy. The SPSS software was used for the data analysis of the collected data. Results: Results of this study showed the significant effect (p<0.01) of chest physiotherapy upon forced expiratory volume in first second (FEV1) (baseline mean, 44.19 immediately after intervention mean 47.3 and 20 minute after intervention mean 48.3) and forced vital capacity (FVC) (baseline mean, 69.37 immediately after intervention mean, 73.67 20 minute after intervention 75.74). Chest physiotherapy had significant effect (p<0.01) in asthmatic bronchitis group and also had significant effect (p<0.05) in both severe and moderate groups. Conclusion: Chest physiotherapy was able to improve pulmonary function test indices in chemical warfare victims suffering from respiratory problems. The effect on asthmatic bronchitis group, as well as both severe and moderate groups, was significant.

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Introduction & Objective: Brachytherapy using I-125 radioactive seeds in removable episcleral plaques (EP) is often used in treatment of ocular malignant melanoma. Some radioactive seeds are fixed in a gold bowl-shaped plaque. The plaque is sutured to the sclera surface corresponding to the base of the intraocular tumor, allowing for a localized radiation dose delivery to the tumor. Minimum target doses as high as 85Gy are directed at malignant tumor. The aim of this study was to develop a Monte Carlo simulation of an ocular plaque in order to calculate the resulting isodose distributions. Materials & Methods: The MCNP-4C Monte Carlo code is used to simulate the plan of an episcleral plaque treatment. A 20-mm Collaborative Ocular Melanoma Study (COMS) plaque with 3, I-125 seed of model 6711 was used. Resulting dose distributions, including central axis dose and off-axis dose profiles, were calculated in a water phantom with 12mm radius. The calculated dose distributions were compared to the corresponding dose measured by Knuten et al., 2001. Results: Central axis dose calculations represent a rapid dose fall off, which is an important factor in selection of appropriate eye plaque for management of tumors with known dimension. Calculated off-axis dose profiles show decreased dose uniformity at distances close to the plaque. Increasing of distance from the plaque resulted in increasing of the dose uniformity. Conclusion: Monte Carlo simulation of eye plaques can be used as a useful tool in process of design, development and treatment planning of ocular radioactive plaques.

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Introduction & Objective: Stress is one of the most important phenomena in this century that has had a great impact on people’s mental and physical health and has become one of the main topics of organizational management. Primarily, nursing and taking care of patients is stressful itself. Therefore, in the working environment, any menace to organizational goals and reduction in the quality of nursing cares are due to stress. There are different therapeutic ways to deal with stress which cognitive behavioral therapy is one of them. The goal of this study was to examine the effects of cognitive behavior therapy on stress among nurses who worked at Yasuj Shahid Beheshti hospital in 2009. Materials & Methods: This was an experimental research that was carried out among 100 nurses working at Yasuj Shahid Beheshti hospital in 2009. The sampling type was available samples. After filling the DASS-42 questionnaire, we chose 30 cases that had the worst status from point of stress and were randomly divided into two groups: case and control groups. Each group consisted of 15 nurses. The cases were trained in 8 weeks, an hour a week, by a single clinical psychologist specialized in cognitive behavioral therapy. After the therapy, questionnaires were filled again by the two groups. Finally, two groups were compared together in view point of stress scores. For analysis of data we used the SPSS software and descriptive statistics, t-test and ANOVA. Results: The mean and standard deviations of stress in case group on the pre-test were7.96±18.73 and on the post test were 6.295±12.266 respectively, the mean and standard deviations of stress in the control group for pre-test were 8.413±21.066 and for post test were 9.019±20.733 respectively. There weren’t any significant differences between two groups before the intervention, but there were significant differences between case groups after the intervention. (p < 0.05). Conclusion: According to the findings of the study, cognitive behavioral techniques' training significantly reduces stress in nurses. Therefore, it is recommended to reduce nurses’ stress and increase the level of nursing services and promoting patients’ satisfaction by establishing a psychology consulting unit in hospitals.

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Introduction & Objective: Diabetes, i.e. lack of proper control of blood sugar, may cause serious complications in patients. The objective of this study was to assess the influence of electrical muscle stimulation on glucose control in type 2 diabetes mellitus. Materials & Methods: This clinical-trial study was conducted in 2009, in Shiraz, Iran. Forty nine diabetes mellitus patients, Type 2, participated in this study. In 28 cases, dietary and exercise modifications were recommended and electrical muscle stimulation was carried out. For the other 21 cases, only dietary and exercise modifications were recommended. Laboratory tests, including fasting blood sugar (FBS) and glucose tolerance test (GTT), was performed before the study and 6 weeks afterward. The results were analyzed by SPSS version 15.5 software and using t-test. Results: The mean of FBS in the case group before EMS was 156 mg/dl and 6 weeks later changed to 123 mg/dl (p < 0.05), while in the control group these indices were 158 mg/dl and 154 mg/dl respectively. The mean of GTT in patients before EMS was 193 mg/dl and 6 weeks later became 150 mg/dl (p < 0.05), whereas in the control group these figures were 204 mg/dl and 201 mg/dl respectively. Conclusion: The results of this study confirmed that the use of electrical muscle stimulation can be effective on glucose control in type 2 diabetes mellitus.

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Introduction & Objective: Social phobia is an anxiety disorder, which can be described as a strong, persisting fear of situations where humiliation or embarrassment may occur. The purpose of this study was to determine the effect of meta-cognitive therapy (MCT) on symptoms of social phobia (SP) patients. Materials & Methods: This semi-experimental study was conducted in 2010. with pretest-posttest and follow-up design, using control group. From all social phobia disorder (SPD) patients referring to psychology clinics in Shiraz, Iran in 2010, 19 patients were selected through the objective sampling method and were randomly divided into two experimental and control groups. The Social Phobia Symptoms Assessment Questioner (SPSAQ) and Fears of Negative Evaluation Scale (FNE) were used as the pre–test measures. The experimental group received 8 weeks of Wells’ meta-cognitive therapy sessions. The control group was in the waiting list until the end of the follow up. The same measures were used for post–test and follow–up (after 3 months). Results: The results of analysis of multivariate covariance showed that MCT had a significant effect in reducing the symptoms of SPD (p<0.001). Conclusion: This intervention is believed to reduce symptoms of social phobia (SP) patients by facilitating transmission from the object mode to the meta cognitive mode and enhancing the efficient and flexible coping skills.

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Introduction & Objective: The effect of touch on the growth of newborns has been achieved by educated staff, but touch therapy by mothers, as the most important care provider for their infants, has not been focused in previous studies. Materials & Methods: In this randomized controlled trail and double blind study which was conducted at Tehran University of Medical Sciences in 2010, 60 preterm newborns, which were discharged from neonatal intensive care unit (NICU) , were randomly allocated to a control and a touch therapy group (30 newborns in each group). Touch therapy was directly instructed to the mother, also offering guide booklets to the mother. Touch was provided by mother for three periods, 20 minutes each, per day, until term corrected age. In two groups, neonate weight by the electronic weighing scale with an accuracy of ± 10 grams, height with an infant meter, also head and chest circumference with a non-stretchable cloth-tape were measured at the time of discharge following the term corrected age. The statistical data was analyzed by the SPSS software using Kolmogrov Smirnov, Mann-Whitney, Chi-square, Independent T-test and Fisher test. Results: The mean age, type of delivery, level of education, employment and socio-economic status in mothers of the two groups, also weight, sex and other neonate characteristics had no statistical differences. At the term corrected age, there were no differences in mean of height, head and chest circumference between two groups, but the interventional group showed an average weight gain more than the control group, (3373± 270.3 , 2905± 372.6 gr) which was statistically significant (p=0.04). It means that neonates in intervention group gained 468 grams more than the control group. Conclusion: Between all anthropometric measurements, only weight was affected by touch therapy. This might be due to the speed of weight gaining compared to increase in height, head and chest circumference.

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Background & Aim: Electroconvulsive therapy (ECT) is a highly effective treatment for affective and schizophrenic disorders. The main objective of this study was to examine the cognitive effects of ECT in patients with major depressive, bipolar and schizophrenia disorders. Methods: In this study we administered a battery of cognitive tasks on 90 patients with major depressive, bipolar and schizophrenia disorders, one day before and after the termination of ECT. The effects were measured by a set of computerized cognitive tests including: auditory reaction time, visual reaction time, verbal memory, Benton visual memory, Wisconsin card sort and motor function. The collected data were analyzed using One-way ANOVA and dependent t-test. Results: The results showed that depressive patients had poorer verbal memory and motor function after the termination of ECT compared to pretest, but their executive function was improved (p<0.05). After the termination of ECT the verbal and visual memory and executive function was significantly improved in patients with bipolar and schizophrenia disorders but their motor function was significantly reduced (p<0.05). Conclusion: Results of this study showed improvement for most cognitive functions in patients after electroconvulsive therapy. Findings of this study may help patients and their families to overcome their fear of electroconvulsive therapy. The results also can aware patients regarding the cognitive effects of electroconvulsive therapy.

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Background & Aim: The imposed war burdened a lot of problems on the society of Iran during the past few years. In this course, veterans didn’t immune from its harmful effects. The aim of the present study was to determine the effectiveness of integrated group gestalt therapy and cognitive therapy on improvement of quality of life of veterans of city of Jahrom, Iran. Methods: The present clinical trial study was conducted on thirty veterans of Jahrom in 2010. The subjects included all the war veterans of Jahrom, 820 with 25-69 percent physical damage. Random sampling was executed and the world Health Organization life quality questionnaire (WHOQOL-BREF) was given to 150 of them. Fifteen people in each group were replaced by another fifteen people. The test group received eight sessions of group consultation in Gestalt therapy and cognition therapy ways, but the control group received no therapy. The gathered data was analyzed using ANOVA test. Results: The result of this study showed that-there is a significant difference between the life quality dimensions (physical health, mental health, life environment and social relations) between the test and control group (p=0.001). Conclusion: The results of this study showed that the integrated of group counseling by gestalt therapy and cognitive therapy had an influence on increasing the veteran’s life qualifications in aspects of physical health, mental health, life environment and social relations.

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Abstract Background & aim: Nowadays, most of gene therapy protocols are performed by lentiviral vectors. One of the most important factors which is involved in pancreas development and transcription of insulin gene is pancreatic & duodenal homeobox 1 (PDX-1) transcription factor. The goal of this study was to optimize a lentiviral construct, containing pdx-1 gene, to transfect stem cells towards gene therapy of type-1 diabetes. Methods: In this experimental study, first, the pdx-1 gene was multiplied by PCR from pcDNA3.1-pdx-1 and cloned into pTG19-T vector. Then, pdx-1 was subcloned on upstream of IRES-EGFP gene into IRES2-EGFP vector. At the next step, the cloned parts of IRES-EGFP and pdx-1 were isolated and cloned into the lentiviral expression vector pSINTREM in upstream of TRE-CMV gene. After sequencing, final construct was transfected into HEK 293 cells and gene expression of pdx-1 was evaluated using flow cytometry analysis and reverse fluorescent microscopy. Results: Flow cytometry results and inverted fluorescent microscopy observing showed that pdx-1 and GFP genes are expressed in cells transfected with final recombinant construct. Conclusion: Regarding the design of this construct, to ensure long time expression with higher in vivo and in vitro expression efficiency for stem cells and also use of Tet on induced optimized system, it seems that the current construct can be among the best ones to transfect stem cells. Key words: Gene therapy, Diabetes, Stem cells

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Abstract Background and aim: Post-traumatic stress disorder is considered as set of symptoms developed afterward an individual witness, hear or involved. The current research was purposed to compare the efficacy of eye movement desensitization and reprocessing therapy with prolonged exposure therapy on the trauma impact symptoms in veterans suffering from chronic PTSD. Methods: in this clinical trail research randomly sampled 48 veterans diagnosed with PTSD who had psychiatric records in Salman City Hospital of Yasuj. The subjects devoted in three equal groups: two experimental and one control groups. As intervention procedures the two experimental groups were exposed to eye movement desensitization and reprocessing therapy (5 sessions) and prolonged exposure therapy (10 sessions) respectively. The control group received none. Subsequent to the treatment period the triple groups were post-tested by the prior pre test scales. The data were analyzed by implementing univariate analysis of covariance (ANCOVA) and Bonferroni post hoc test. Results: Both treatment procedures significantly reduced the trauma impact symptoms (p ≤0/001).The results also indicated that prolonged exposure therapy was more effective concerning the trauma impact symptoms improvement. Conclusion: Intervention treatment procedures such as eye movement desensitization, reprocessing therapy, and prolonged exposure therapy sustain sufficient efficacy in trauma impact symptoms improvement while prolonged exposure therapy exceeded significantly. Key words: Post Traumatic Stress Disorder, Eye Movement, Desensitization, Reprocessing, Prolonged Exposure Therapy

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Abstract Background & aim: Considering the fact that infertility causes infertility problems in the marital relationship so, this study was aimed to determine the effectiveness of short-term couples therapy self-regulation on marital intimacy of infertile. Methods: In this clinical trial study, 20 couples were selected for sampling then they randomly into two experimental and control groups and each group was assigned 10 couples. Marital Intimacy scale was used to collect the data. Experimental intervention (self-regulatory couple therapy) was conducted on the experimental group for 8 sessions in duration of 90 minute per week. One month after completion of the training program, both groups were post-tested. Repeated measure was used to analyze the data. Results: The results showed that infertile couples marital intimacy increased self treatment groups compared with the control group (p<0.001). Conclusion: Short-term couple's therapy self-regulation is effective for increasing marital intimacy. Key words: Self-regulation, Couple Therapy, Marital Intimacy, Infertility

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Abstract Background & aim: Pain and limited range of motion (ROM) are the crucial subsequent results of joint hemorrhages in patients suffering from hemophilia. Different training protocols designed to treat these patients are of great importance. The purpose of this study was to compare the effects of drought and water therapy on pain and range of motion of the knee in hemophilia patients. Methods: In this present clinical-trial study, 40 patients with hemophilia type A were randomly divided into three groups: exercise therapy on land, hydrotherapy, and control groups. The first two groups attended their special exercises on three days within 4 weeks, but the control group were only subjected to their daily life activities. Experimental pain, flexion and knee extension were measured using a visual analogue scale (VAS) and standard Goniometer at the beginning and after the intervention. Data were analyzed by ANOVA and Scheffe’s test (P<0.05). . Results: Both experimental groups exhibited significant reduction of pain along with improved knee flexion and extension compared with the control group (P<0.001). Pain reduction in subjects treated in water treatment was significantly higher than exercise group in drought (P<0.001), but no significant changes was seen in flexion and knee extension of the two exercise groups (P>0.05). Conclusion: The use of therapeutic exercise in water with regular exercise rehabilitation for patients with hemophilia can be helpful to reduce pain and improve range of motion in hemophilia patients. The effect of exercise therapy on pain reduction is more effective compared to traditional pain therapy. Key words: Hydrotherapy, Exercise Therapy, Hemophilia, Knee Range of Motion

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Abstract Background & aim: Myocardial infarction is one of the most common cardiovascular diseases. Streptokinase is used in patients with myocardial infarction with ST-segment elevation. The aim of this study was to compare the side effects of intravenous streptokinase in acute myocardial infarction patients in different age groups. Methods: In the present analytic descriptive study, the samples included 100 eligible patients which received intravenous streptokinase. The research instrument was a questionnaire consisting of two parts: the first part was used to measure the underlying data and the second part to evaluate the side effects of intravenous streptokinase,. Data were analyzed by chi-square statistical tests. Results: There were no significant adverse events between intravenous streptokinase and different age groups ((P>0.05).). The most common side effects of this drug were cardiovascular complications in different age groups. Conclusion: the use of streptokinase intravenous drug in different age groups is associated with risk of cardiovascular complications. Key words: age, side effects, streptokinase, acute myocardial infarction, thrombolytic therapy, ST elevation

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Background & aim: Despite the wide variety methods of psychological therapies for the treatment of post-traumatic stress disorder, still a significant number of patients do not respond to treatment or show a low relatively improvement. The aim of this study was to evaluate the effectiveness of schema therapy in reducing the early severity of maladaptive schemas of male veterans with post-traumatic stress disorder. Methods: The present experimental study was conducted on three male veterans with post-traumatic stress disorder. Twenty one sessions of therapy was performed according to the Young's model scheme for changing the rate and severity of early maladaptive schemas on the subjects at the end of the protocol and were reassessed follow-up treatment during the two-month. Research tools consisted of a short questionnaire form of the Young, Schema Questionnaire, Young Compensation Inventory, and Young Shun - vote, Millon Clinical Multiaxial Inventory Scale, Clinician Administered PSDS, Mississippi for post-traumatic stress disorder and comprehensive international diagnostic interview. Results: The findings showed that the Schema therapy reduced the severity of maladaptive schemas in patients with post-traumatic stress disorder and follow-up period of treatment indicates the consistency of treatment. Discussion: Schema therapy targeting the root growth impairment and restructuring of maladaptive schemas able to treat persistent symptoms of post-traumatic stress disorder and decreased their incompatible schemas activity.

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Background & aim: Among the problems affecting the mental health of war veterans is post traumatic stress disorder. The aim of the present study was to investigate the effectiveness of Gestalt therapy on post traumatic stress disorder (PTSD) symptoms on veterans of Yasuj city, Iran. Methods: The research design was based on pre-post test study with control group and a three month followed-up. The research population included veterans who were referred to Salman hospital and had been diagnosed of having PTSD. The sample included 24 veterans with PTSD which were randomly selected and divided into two groups of experimental and control (n=12). The Post Traumatic Stress Disorder Mississippi Scale (M-PTSD) administered before training for both groups was used to assess symptoms of PTSD. The experimental group was exposed to Gestalt therapy interventions in six, 90 minute weekly sessions. Both groups were conducted measurements after the first, third, fifth and seventh therapy sessions. The data were analyzed using ANCOVA. Results: The results in the post-test stage revealed that Psychological Debriefing and behavioral interventions reduced PTSD symptoms (p<0.01), as well as, the results in followed up stage revealed that Psychological Debriefing and behavioral interventions reduced PTSD symptoms (p<0.05). Conclusion: Gestalt therapy technique can be used as a standard in conjunction with other treatments which can be used to improve the symptoms of post-traumatic stress disorder.